Advancing safe, high-quality radiotherapy for all Canadians
Radiotherapy is one of the most widely used cancer treatments in Canada — and one of the most technically complex. As technology evolves rapidly, so does the need for rigorous national standards, ongoing quality assessment, and a coordinated approach to patient safety.
The Canadian Partnership for Quality Radiotherapy (CPQR) exists to meet that need. As a standing committee of CAPCA, CPQR drives practice harmonization, strengthens quality and safety, and supports equitable access to radiotherapy across the country.
Participation in CPQR includes provincial cancer agency and program radiotherapy experts, such as radiation oncologists, medical physicists, radiation therapists, radiation oncology nurses, and patient and family advisors with lived experience.
A pan-Canadian collaboration in action
CPQR brings together the professionals and organizations whose expertise is essential to radiotherapy quality and safety:
- Canadian Association of Medical Radiation Technologists (CAMRT)
- Canadian Association of Nurses in Oncology (CANO-ACIO)
- Canadian Association of Radiation Oncology (CARO)
- Canadian Organization of Medical Physicists (COMP)
The Institute for Safe Medicine Practices Canada (ISMP Canada) Canada partners with CPQR on the National System of Incident Reporting – Radiation Treatment (NSIR-RT), a tool for cancer centres to report, track and analyze safety incidents to drive accountability and continued improvement in radiotherapy quality.
Accreditation Canada collaborates with CPQR to keep cancer care standards current. Operational costs are supported in part by the Canadian Partnership Against Cancer.
CPQR Resources
Guidelines, self-audit tools, patient-reported outcome measures, and more.
Priority areas
CPQR and its partners are active across every dimension of radiotherapy quality. Select a focus area to learn more.
A culture of safety depends on the ability to report, analyze, and learn from incidents — including near-misses. CPQR supports the National System for Incident Reporting – Radiotherapy (NSIR-RT), through which radiotherapy centres across Canada can log potential and actual treatment incidents in granular detail, benchmark against national data, and act on findings from other programs across the country.
This system was originally developed in partnership with the Canadian Institute for Health Information (CIHI), whose contributions were instrumental in establishing a national infrastructure for radiation treatment incident reporting. As of April 2026, this system is maintained in partnership with the Institute for Safe Medicine Practices Canada (ISMP Canada), ensuring that learnings are captured and shared consistently to drive ongoing improvement in radiotherapy safety.
CPQR develops and maintains two complementary sets of guidelines that together define the national standard for radiotherapy quality:
- The Quality Assurance Guidelines for Canadian Radiation Treatment Programs set out expectations for how radiotherapy programs should be organized, managed, and continuously improved. These guidelines are regularly reviewed to keep pace with advances in technology and clinical practice.
- 17 technical quality control guidelines address the performance and safety of radiotherapy equipment at the treatment delivery level. These guidelines are reviewed and updated by the Canadian Organization of Medical Physicists (COMP), which also supports their adoption across radiotherapy programs nationally.
A partnership with Accreditation Canada ensures that cancer care standards reflect current radiotherapy practice and remain aligned with CPQR guidelines — and vice versa.
Radiotherapy utilization (RTU) — the proportion of cancer patients who receive radiotherapy — is one of the clearest indicators of whether patients are getting the care they need. Past RTU assessments across several provinces have revealed gaps relative to established benchmarks, suggesting that some patients who would benefit from radiotherapy are not receiving it.
CPQR monitors provincial RTU data on an ongoing basis and makes recommendations to provincial cancer programs to support better, more equitable access to care.
Understanding the patient experience is integral to improving radiotherapy quality. This work — now advanced by the Canadian Association of Radiation Oncology (CARO) — has resulted in:
- An endorsed set of five patient-reported outcome (PRO) measures for specific disease sites, supporting consistent collection of patient experience data across radiotherapy programs
- Guidance documents to help radiotherapy programs engage patients and their families consistently at every stage of the care journey:
Realizing the potential of radiotherapy data requires consistent collection, standardized formats, and the infrastructure to share and analyze information at scale. CPQR’s foundational work on the Canadian Big Radiotherapy Data Initiative helped radiotherapy programs adopt common systems and prepare for pan-Canadian data sharing. The Canadian Organization of Medical Physicists (COMP) is leading continued efforts to collect and analyze treatment plans and clinical data nationwide.
CPQR is also working to advance pan-Canadian radiation treatment data harmonization as part of the broader Pan-Canadian Cancer Data Strategy.
Radiotherapy centres across Canada are expected to regularly assess the quality of their own programs against national standards.
CPQR’s self-audit tools support this process by providing a structured framework – grounded in the technical quality control guidelines – for programs to evaluate their practices, identify gaps, and drive continuous improvement.
Updated self-audit tools are in development and will be available in Spring 2026.
Addressing human resource challenges that threaten the sustainability of high-quality radiotherapy delivery.
Building new and enhanced collaborations to strengthen the long-term impact of CPQR’s work.
Implementing a pan-Canadian radiotherapy emergency preparedness and cybersecurity framework.
Latest Updates
Radiotherapy data standards: TG-263 and O3 Resources
In 2024, the Canadian Partnership Against Cancer (CPAC) and the Canadian Cancer Society published a Pan-Canadian Cancer Data Strategy to help strengthen how cancer data are collected, shared, and used across Canada.
As part of this work,…
Guidance tree for handling events within the BCPSLS
Since 2020, British Columbia has been electronically transferring
radiation treatment safety event data to NSIR-RT following the
implementation of a formal data-sharing agreement between CIHI and
the BC Patient Safety and Learning System (BCPSLS).
To support accurate data entry, BC has developed several…
“Quality assurance is a key focus for radiation treatment programs. By working collaboratively and focusing on adoption of best practices, we ensure patients receive the best care across jurisdictions.”
Jean-Pierre Bissonette, Associate Head for Professional and Academic Affairs for the Department of Medical Physics at the Princess Margaret Cancer Centre; Co-Chair, Canadian Partnership for Quality Radiotherapy (CPQR)
